Table III.

Meta‐Analyses and Systematic Reviews Evaluating DHP and Non‐DHP Calcium Antagonists in Hypertensive Populations

Trial Author, Publication Year/Number of Trials (n)	CCB vs. Comparator Agent(S)/Number of Patients (n)/Duration of Follow‐up	Blood Pressure and Primary Outcome Results (CCBS vs. Comparator)
Pahor et al., 2000 26 n=9	Amlodipine, diltiazem, felodipine, isradipine, nicardipine, nifedipine, nisoldipine, or verapamil (N=12,669) D, BB, ACEI, or clonidine (N=15,044) (“other agents”) 2–7 years	No significant differences in SBP or DBP reduction but MI 1.26 (1.11–1.43; p=0.0003); HF 1.25 (1.07–1.46; p=0.005); combined major CV events 1.10 (1.02–1.18; p=0.018) Similar risks for stroke 0.90 (0.80–1.02), all‐cause mortality, CV mortality, and non‐CV mortality
Opie and Schall, 2002 27 n=6	Diltiazem, felodipine, isradipine, nicardipine, nifedipine, or verapamil (N=12,116) D or BB (N=12,206) 2–6 years	BP: no data provided Nonfatal stroke 0.84 (0.74–0.96; p=0.013); nonfatal MI 1.18 (1.01–1.37; p=0.036). (Note: After Bonferroni correction for multiplicity; p=0.052 for nonfatal stroke and p=0.144 for nonfatal MI) Similar risks for fatal stroke, fatal MI, total mortality, CV mortality, and major CV events
Staessen et al., 2003 28 n=9	Amlodipine, diltiazem, felodipine, isradipine, lacidipine, nicardipine, nifedipine, or verapamil (N=30,520) D or BB (N=36,915) 2–6 years	BP: no data provided Fatal and nonfatal stroke: 0.92 (0.84–1.01; p=0.07), if exclude verapamil (CONVINCE trial) 0.90 (0.82–0.98; p=0.02); CHF: 1.33 (1.22–1.44; p<0.0001) Similar risks for total mortality, CV mortality, all CV events, and MI
Trialists, 2003 29 n=29 (17 of which included CCBs)	Amlodipine, diltiazem, felodipine, isradipine, lacidipine, nicardipine, nifedipine, nisoldipine, nitrendipine, verapamil CCB (N=3794) vs. placebo (N=3688) 2.6–3.0 years CCB (N=31,031) vs. D/BB (N=37,418) 2–5 years CCB (N=12,998) vs. ACEI (N=12,758) 3–5.3 years	CCB vs. placebo: SBP:–8.4 mm Hg and DBP:–4.2 mm Hg Stroke 0.62 (0.47–0.82), CHD 0.78 (0.62–0.99), major CV events 0.82 (0.71–0.95), CV death 0.78 (0.61–1.00); HF 1.21 (0.93–1.58); total mortality 0.89 (0.75–1.05) ] CCB vs. D/BB: SBP: 0.8 mm Hg and DBP:–0.2 mm Hg Stroke 0.93 (0.86–1.00); HF 1.33 (1.21–1.47) No statistical difference in the incidences of death or other CV outcomes CCB vs. ACEI: SBP:–0.6 mm Hg and DBP:–0.9 mm Hg CCBs trended toward 12% (1–25) risk reduction in stroke, while ACE inhibitors significantly reduced HF by 18% (0.82 [0.73–0.92]) No statistical difference in the incidences of death or other CV outcomes
Psaty et al., 2003 30 n=42 (total of 14 CCB trials, 8 of which qualified for the low‐dose diuretic comparison)	Amlodipine, diltiazem, felodipine, isradipine, nicardipine, nifedipine, verapamil (no short‐acting agents) (N=29,343) Low‐dose diuretics (N=35,758) 2–5 years (for the eight CCB trials)	Low‐dose diuretics vs. CCBs: No difference between groups in change in SBP or DBP HF 0.74 (0.67–0.81; p<0.001); CV disease events 0.94 (0.89–1.00; p=0.045) No significant differences in death or other CV outcomes, including stroke CCBs were significantly better than placebo in all these outcomes.
DBP=diastolic blood pressure; ACEI=angiotensin‐converting enzyme inhibitor; BB=β blocker; CCB=calcium channel blocker; CHD=coronary heart disease; CV=cardiovascular; D=diuretic; DHP=dihydropyridine; HF=heart failure; MI=myocardial infarction; SBP=systolic blood pressure